Editor’s note: This commentary is by Scott Pavek, of Burlington, who is a recovery advocate and Democratic candidate for the state House of Representatives for the Chittenden 6-5 seat.
I first used opioids when I was 16 years old. After years of visiting emergency rooms, fraying relationships and saying goodbye to loved ones, I entered recovery at the age of 22. I’m now approaching my 29th birthday — a milestone I once would have thought unattainable — which means I’ve spent just about 13 years living in the “opioid crisis.”
Frankly, I’m a little over it.
I’m tired of reading about people being arrested for exhibiting symptoms of a medical condition. I’m sick of waiting to see how interventions play out elsewhere, wondering when we’ll have the bold leadership in Vermont required to do things differently. I’m frustrated by complacency in light of incremental “progress.” I’m heartbroken by all the obituaries of people dying preventable deaths after living lives they did not want for themselves.
Aren’t you?
What if we decided, collectively, to end the opioid/overdose crisis? What if we owned this goal and took the necessary action to realize it? What if our actions matched our rhetoric?
What if we, well, cared? What would that look like?
I’ve got a few ideas:
1. Legalize overdose prevention sites. Passing a bill at the state level doesn’t mandate we save lives. This legislation wouldn’t require spending. Instead, this change would signal to municipalities and nonprofit organizations that should they choose to be compassionate and fearless, the state will not bring criminal charges for saving lives.
2. Decriminalize buprenorphine. When a person with substance use disorder uses buprenorphine in place of other opioids (usually of questionable purity), that person reduces their chance of overdose and death. We should encourage people to make safer decisions, not penalize them for doing so. We’ve seen this policy have positive impacts in Chittenden County; it’s time to bring some geographic equity to recovery in our state.
3. Distribute fentanyl test strips. So long as the illicit opioid market hasn’t been completely dominated by fentanyl, test strips will continue to have utility. In light of increasing overdoses involving multiple substances, drug testing supplies are critical. Further, research shows that when people are able to assess the potency of drugs, they modify their behavior to match perceived risk.
4. Provide safe-use supplies through the mail. Imagine if you had to drive hours each day to acquire medicine to keep you alive. It would certainly impact your ability to maintain a normal routine, hold down a job, pursue an education, etc. This is the reality many people with opioid use disorder, especially outside of Chittenden County, face today. For people living in southern Vermont, generally, clean syringes and naloxone may only be accessed during limited hours at a handful of locations. We can alleviate a tremendous opportunity cost associated with using drugs with greater safety.
5. Facilitate recovery and treatment-in-place for families. It’s often said in recovery circles that individuals need to change their “people, places and things,” when attempting to abstain from drug use. For many people, this simply isn’t true, especially for individuals caring for young children. I’ve turned treatment down in the past for fear of being disconnected from my loved ones; I’ve witnessed peers forgo long-term treatment stays because of restrictions on visitation. Our programs and policies related to substance use disorder and recovery ought to focus on cultivating supportive relationships which already exist.
In my estimation, each of the ideas listed above is actionable. Implementing the above policy changes do not first require reform at the federal level. Moving forward with any of these ideas is a question of political will. And unlike safe supply programs or vending machines piloted by our friends in Canada, none of these proposals necessitate spending.
This list is, of course, not exhaustive. If we understood substance use disorder as a medical condition and regarded health care as a right, our policies would certainly go further. Still, these ideas stand out to me as reasonable first steps for any legislator (a) committed to saving lives and (b) brave enough to embrace evidence-based policy, controversy or electoral consequences be damned.
Next legislative session, let’s end the relative inaction and begin treating crises like crises. Lives are at stake.
